The Unbreakable Circle: An Intellectual History of Michel Foucault

The following is a chronologically ordered internal intellectual history of Michel Foucault. The objective of this analysis is to determine whether or not Foucault provides a viable critical social theory of bourgeois society. In order to examine this topic, I trace the development of Foucault’s thought during his early, pre-archaeological stage, his archaeological stage, and his genealogical stage. I frame Foucault’s stages as attempts to overcome Kant’s subject/object division—or the paradox that man operates as both a meaning-giving subject and an empirical object—that one encounters in discourses pertaining to the social sciences. Foucault’s pre-archaeological stage is characterized by two humanistic modes of thought: hermeneutics and phenomenology. Hermeneutics involves the interpretation of historical events in pursuit of existential meaning. By contrast, phenomenology seeks to uncover meaning in subjective experience. After the publication of Mental Illness and Psychology, Foucault rejects hermeneutics and phenomenology on the grounds that the search for meaning through interpretation will inevitably obscure truth under endlessly multiplying interpretations. Neither method offers a coherent resolution to the subject/object division. Foucault’s archaeological method attempts to overcome the subject/object division by studying the relationships—or patterns appearing in language—between empirical observations. Archaeology does not account for the truth-value associated with codified empirical observations (or statements). In other words, archaeology studies the language patterns comprising claims to objective truth. Archaeology consequently assumes a relativistic and objective position that escapes the subject/object division. However, this method suffers from internal instabilities; the rules governing language pertaining to empirical observation are objective, yet the analysts are themselves a product of these rules. This contradiction casts doubt up archaeology’s claim to objectivity. Foucault’s genealogical method does not seek to resolve Kant’s subject/object division; rather, genealogy embraces the notion that the interaction between subject and object remains unknowable. Genealogy, therefore, retains archaeology’s relativistic stance regarding claims to truth while forgoing the former method’s pursuit of objective analysis. During his genealogical stage, Foucault directs his attention away from language patterns and toward the interaction between power and knowledge. Foucault conceptualizes power as a multidirectional, decentralized, and self-perpetuating force that manifests itself as the material result of interpersonal, institutional, and society-level conflicts. Knowledge complements power by defining normal and abnormal behavior. In doing so, knowledge establishes the cognitive field comprising the individual’s self-concept. Genealogy is an analytic of the power/knowledge interaction; the method provides a relativistic means of conceptualizing the reciprocal influence between force relations and discourses. While genealogy does not constitute an objective critical theory, the method has a concrete basis in the form of the positive manifestations of the power/knowledge interaction. Based on my assessment of the above methods, I conclude that genealogy is a viable social theory. Moreover, Foucault consistently deconstructs narratives comprising bourgeois society. From this recurrence it is apparent that Foucault is a para-Marxist; he provides a critique of bourgeois society and attempts to test the limits of individual experience within that society. This conclusion supports the continued relevance of Foucauldian analysis in the social sciences

Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner

High tibial osteotomy (HTO) is a surgical procedure used to change the mechanical weight-bearing axis and alter the loads carried through the knee. Conventional indications for HTO are medial compartment osteoarthritis and varus malalignment of the knee causing pain and dysfunction. Traditionally, knee instability associated with varus thrust has been considered a contraindication. However, today the indications include patients with chronic ligament deficiencies and malalignment, because an HTO procedure can change not only the coronal but also the sagittal plane of the knee. The sagittal plane has generally been ignored in HTO literature, but its modification has a significant impact on biomechanics and joint stability. Indeed, decreased posterior tibial slope causes posterior tibia translation and helps the anterior cruciate ligament (ACL)-deficient knee. Vice versa, increased tibial slope causes anterior tibia translation and helps the posterior cruciate ligament (PCL)-deficient knee. A review of literature shows that soft tissue procedures alone are often unsatisfactory for chronic posterior instability if alignment is not corrected. Since limb alignment is the most important factor to consider in lower limb reconstructive surgery, diagnosis and treatment of limb malalignment should not be ignored in management of chronic ligamentous instabilities. This paper reviews the effects of chronic posterior instability and tibial slope alteration on knee and soft tissues, in addition to planning and surgical technique for chronic posterior and posterolateral instability with HTO

A theoretical framework to describe communication processes during medical disability assessment interviews

BACKGROUND: Research in different fields of medicine suggests that communication is important in physician-patient encounters and influences satisfaction with these encounters. It is argued that this also applies to the non-curative tasks that physicians perform, such as sickness certification and medical disability assessments. However, there is no conceptualised theoretical framework that can be used to describe intentions with regard to communication behaviour, communication behaviour itself, and satisfaction with communication behaviour in a medical disability assessment context. OBJECTIVE: The objective of this paper is to describe the conceptualization of a model for the communication behaviour of physicians performing medical disability assessments in a social insurance context and of their claimants, in face-to-face encounters during medical disability assessment interviews and the preparation thereof. CONCEPTUALIzATION: The behavioural model, based on the Theory of Planned Behaviour (TPB), is conceptualised for the communication behaviour of social insurance physicians and claimants separately, but also combined during the assessment interview. Other important concepts in the model are the evaluation of communication behaviour (satisfaction), intentions, attitudes, skills, and barriers for communication. CONCLUSION: The conceptualization of the TPB-based behavioural model will help to provide insight into the communication behaviour of social insurance physicians and claimants during disability assessment interviews. After empirical testing of the relationships in the model, it can be used in other studies to obtain more insight into communication behaviour in non-curative medicine, and it could help social insurance physicians to adapt their communication behaviour to their task when performing disability assessment

Sarcopenia: etiology, clinical consequences, intervention, and assessment

The aging process is associated with loss of muscle mass and strength and decline in physical functioning. The term sarcopenia is primarily defined as low level of muscle mass resulting from age-related muscle loss, but its definition is often broadened to include the underlying cellular processes involved in skeletal muscle loss as well as their clinical manifestations. The underlying cellular changes involve weakening of factors promoting muscle anabolism and increased expression of inflammatory factors and other agents which contribute to skeletal muscle catabolism. At the cellular level, these molecular processes are manifested in a loss of muscle fiber cross-sectional area, loss of innervation, and adaptive changes in the proportions of slow and fast motor units in muscle tissue. Ultimately, these alterations translate to bulk changes in muscle mass, strength, and function which lead to reduced physical performance, disability, increased risk of fall-related injury, and, often, frailty. In this review, we summarize current understanding of the mechanisms underlying sarcopenia and age-related changes in muscle tissue morphology and function. We also discuss the resulting long-term outcomes in terms of loss of function, which causes increased risk of musculoskeletal injuries and other morbidities, leading to frailty and loss of independence